ACLS QUESTIONS WITH COMPLETE SOLUTIONS GRADED TO PASS

In cardiac arrest when do you first introduce medical intervention? Which drug? - after 2 rounds of cpr/shock After 2nd shock give 1 mg epinephrine every 3-5 minutes When do you introduce amiodarone during cardiac arrest? - after the 3rd shock give 300 mg bolus of amiodarone If second dose is needed give 150mg as second dose What rhythms are shockable in cardiac arrest - vf Vt What rhythms are not shockable in cardiac arrest - asystole Pea If you are in an unshockable rhythm arrest when do you give epi - 1mg epi every 3-5 minutes after 1st round of cpr What do you do after return of spontaneous circulation - maintain o2 sat at 94% Treat hypotension (fluids vasopressor) 12 lead ekg If in coma consider hypothermia If not in coma and ekg shows stemi or ami consider re-perfusion What are the 5 h's and 5 t's - hypovolemia Hypoxia Hydrogen ion (acidosis) Hypo/hyperkalemia Hypothermia Tension pneumothorax Tamponade, cardiac Toxins Thrombosis, pulmonary Thrombosis, coronary How do you treat non-symptomatic bradycardia - monitor and observe What constitutes symptomatic bradycardia - hypotension Altered mental status Signs of shock Chest pain Acute heart failure How do you treat symptomatic bradycardia - 1. Give 0.5mg atropine every 3-5 mins to max of 3mg If that doesn't work try one of the following: Transcutaneous pacing 2-10mcg/kg / minute dopamine infusion 2-10mcg/minute epinephrine infusion What is considered a tachycardia requiring treatment - over 150 per minute When do you consider cardioversion - if persistent tachycardia is causing: Hypotension Altered mental status Signs of shock Chest pain Acute heart failure If persistent tachycardia does not present with symptoms what do you need to consider - wide qrs? Greater than 0.12 seconds If persistent tachycardia without symptoms does have a wide qrs what to do you do? - iv access and 12 lead if available